Atrial Septostomy

Atrial Septostomy is a surgical procedure that is done to primarily treat a condition called dextro-Transposition of the Great Arteries (d-TGA). D-TGA is a life threatening cyanotic congenital heart disease that is seen in infants. In this procedure a small hole is created between the upper two chambers of the heart known an Atria.

The normal function of the heart is such that oxygen-depleted blood is pumped from the right side of the heart into the lungs. The lungs oxygenate the blood which is then sent back to the left side of the heart via the pulmonary veins. The Aorta that arises from the left side of the heart, in turn, supplies this oxygen rich blood to the rest of the body, including the heart muscle itself.

In the case of a patient with a d-TGA, certain major blood vessels are wrongly connected. So, the oxygen depleted blood gets pumped into the left side of the heart and transferred through the body by the aorta. The oxygen rich blood in turn, keeps getting pumped into the lung and back to the right side of the heart not allowing it to be circulated. By performing an Atrial Spetostomy it is ensured that more oxygen rich blood gets circulated in the body.

Procedure

There are two kinds of procedures to treat d-TGA.

One is the Balloon Atrial Septostomy, which is also known as Endovascular Atrial Septostomy or Rashkind Atrial Balloon Septostomy.

The second is Blade Atrial Septostomy or Static Balloon Atrial Septostomy .

Normally a baby detected with a d-TGA can survive only a few days after birth with the help of a small hole called as the Foramen Ovale that connects the upper halves of the heart. With the help of this hole, some of the oxygenated blood that keeps going to the lungs can leak through and be circulated around the body. Normally, this hole closes up completely by the time the child is a few days old.

In Balloon Atrial Septostomy a narrow tube, called as a Catheter attached to a deflated balloon is inserted into the Foramen Ovale in the heart. This is usually done by putting the catheter into a blood vessel on the top of the leg and guided into the heart. Once in place in the Foramen Ovale, the balloon is gently inflated to try and make the hole a little bigger so that it does not close completely.

The second method of Blade or Statis Atrial Spetostomy is used if the first procedure has not been successful. In this procedure, a surgical blade is attached to the catheter using which a hole is made between the two halves of the heart. The balloon is then used to enlarge this hole.

The aim of both these procedures is to help the patient survive long enough to have a major surgery done to correct the problem.

Risks

As with any major surgery, there are risks involved. Some of them include:

• Tearing of cardiac tissue
• Arrythmiyas
• Death